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Gastric Dilatation and Volvulus (view source)
Revision as of 11:47, 22 August 2010
, 11:47, 22 August 2010no edit summary
==Description==
==Description==
Gastric Dilatation and Volvulus (GDV) is an acute, life-threatening emergency affecting large and giant breed dogs. The condition is characterized by accumulation of gas in the stomach and malpositioning of the stomach with obstruction of eructation and pyloric outflow. Successful management relies on prompt diagnosis and appropriate emergency treatment as untreated, the the disease will rapidly progress to death.
Gastric Dilatation and Volvulus (GDV) is an acute, life-threatening emergency affecting large and giant breed dogs. The condition is characterized by accumulation of gas in the stomach, malpositioning of the stomach, increased intragastric pressure and shock. Successful management relies on prompt diagnosis and appropriate emergency treatment as the disease will rapidly progress to death if untreated.
Commonly affected breeds include German Shepherds, Great Danes, Irish Wolfhounds, St Bernards and Doberman Pinschers. GDV has also been reported to occur in cats, primates and rarely small breed dogs such as Dachshunds and Miniature Poodles.
Commonly affected breeds include German Shepherds, Great Danes, Irish Wolfhounds, St Bernards and Doberman Pinschers. GDV has also been reported to occur in cats, primates and rarely small breed dogs such as Dachshunds and Miniature Poodles.
==Risk factors==
The exact aetiology of the condition is unknown but a number of risk factors have been identified. Studies have shown that dogs with a reduced thoracic width to depth ratio are at an in increased risk of developing GDV. Female dogs are also more likely to develop GDV than males. Other risk factors include obesity, feeding a dry food diet and exercise after feeding. Stressed, anxious dogs are more likely to develop GDV than calm, placid dogs.
==Pathogenesis==
==Pathogenesis==
An obstruction to gastric emptying due to fluid or gas leads to gastric distention and a rapid increase in intra-gastric pressure. As the stomach dilates, the pylorus shifts through an angle of between 180 and 360<sup>o</sup> from its normal position to a dorsal, cranial and leftward location. More than 90% of all gastric volvuli rotate in a clockwise direction when viewed from the surgeon's perspective with the dog in dorsal recumbency.
An obstruction to gastric emptying due to fluid or gas leads to gastric distention and a rapid increase in intra-gastric pressure. As the stomach dilates, the pylorus shifts through an angle of between 180 and 360<sup>o</sup> from its normal position to a dorsal, cranial and leftward location. More than 90% of all gastric volvuli rotate in a clockwise direction when viewed from the surgeon's perspective with the dog in dorsal recumbency.
In addition to the above systemic effects, diplacement of the stomach may lead to avulsion of the gastric branches of the splenic artery. Significant haemorrhage may occur as a result and this may lead to the development of ischaemia-induced gastric necrosis.
In addition to the above systemic effects, diplacement of the stomach may lead to avulsion of the gastric branches of the splenic artery. Significant haemorrhage may occur as a result and this may lead to the development of ischaemia-induced gastric necrosis.
==History and Clinical signs==
==History and Clinical signs==
The clinical signs of GDV are usually acute in onset and may follow a periood of exercise and/or feeding of a large meal. Affected dogs typically display non-productive vomiting and abdominal distension. On physical examination, the dog may be collapsed or reluctant to stand. Signs of cardiovascular shock may be present including tachycardia, pale mucous membranes, prolonged capillary refill time and poor peripheral pulses. Abdominal tympany is often displayed and the animal may be painful.
The clinical signs of GDV are usually acute in onset and may follow a period of exercise and/or feeding of a large meal. Affected dogs typically display non-productive vomiting and abdominal distension. Acute onset restlessness, abdominal pain, hypersalivation and abdominal typmany are other common features of GDV. On physical examination, the dog may be collapsed or reluctant to stand. Signs of cardiovascular shock may be present including tachycardia, pale mucous membranes, prolonged capillary refill time and poor peripheral pulses. An irregular heart rate combined with pulse deficits indicates the presence of cardiac arrhythmias.
==Diagnosis and Management==
==Diagnosis and Management==